The challenge of providing nutritional support to the dying

Dying patients are often unable to take food or drink; caregivers must then decide whether to provide nutrition/hydration by artificial means. Providing sustenance to such patients is an area of ongoing controversy not least because of the difficulties associated with determining life expectancy but also because of the need to promote patient comfort and well-being. Decisions relating to the provision of nutritional support must be based on the needs, wishes and expectations of both patients and their families. They must also take into account the legal and ethical dimensions of care provision and the need to ensure that the care provided is based on a true examination of the risks, benefits and burdens to the individual. This paper considers these issues concluding that any therapeutic measures considered must be both individualised and realistic recognising that the prime goal must be the patient’s comfort; prolonging his life is of secondary concern.